COVID-19 Command Table

COVID-19 Modelling

April 3, 2020

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COVID-19 Update: Today’s Presentation

• The information provided in this presentation was developed by several experts at Ontario
Health, Public Health Ontario and researchers at Ontario universities, led by the COVID-19
Command Table.
• The objective of today’s presentation is to share the modelling and projection data that the
Command Table has been using to inform our work, and advising government on their
response to COVID-19.
• We feel is it important to be transparent with the public about the challenges we are
facing, and the important work we all need to do to flatten the curve.
• How this outbreak unfolds is in the hands of the public, in all of your hands – we can
change the outcomes by how we all stay at home and physically distance ourselves.
• Recognizing that we get new information about this outbreak on a daily basis, we will
continue to refine our models.
• Our public health measures so far have made a significant difference and we need
everyone to stay focused on these in the weeks ahead: stay home, stop the spread, stay
safe.

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Current Status
COVID-19: Cases and Deaths by Age Group
(January 15 to April 2, 2020)

Age Group Cases Deaths Case Fatality Ratio (%)

19 and under 82 0 0
20-39 945 0 0
40-59 1,178 7 0.6
60-79 821 24 2.9
80 and over 226 36 15.9
Unknown 3 0 0
Total 3,255 67 2.1

Data Source: integrated Public Health Information System (iPHIS). Data extracted April 2, 2020 at 4pm

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COVID-19: Cases in Ontario and Other Jurisdictions

Source: Johns Hopkins University, Centre for System Science and Engineering. Accessed April 1, 2020

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COVID-19: Deaths in Ontario and Other Jurisdictions

Source: Johns Hopkins University, Centre for System Science and Engineering. Accessed April 1, 2020

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 COVID-19: Key Public Health Measures Timeline March 30
– Early
April
Enhance
capacity for
contact
Jan 24 tracing
Minister’s
Order made Closure of
novel March 13 parks and
coronavirus a Essential March 16 outdoor
reportable visitors only Practice recreational
disease in LTC and physical amenities
other distancing Limit outings
Jan 25 - congregate to essentials
February care settings Self-isolate needs
for 14 days if
Rapid testing travelled Self-isolation
ramp-up Stop cycling outside for
of Canada individuals
Aggressive intermittent over 70,
case and inmates and Prohibit compromised
contact personal gatherings immune
management visits in over 50 systems or
of all correctional people March 17 March 21 March 25
facilities March 23 March 24 underlying
confirmed Closure of Work Prohibit medical
cases Make virtual deployment conditions
Prohibit work public Closure of Work gatherings
March 12 gathering for health non-essential deployment greater than
gatherings arrangements services Extended
Closure of over 250 where places and workplaces for LTC 5 people
public people possible establishments providers homes school
schools closure

Second Week Third Week Fourth Week Last Week

of March of March of March of March / Early April

Jan 25 March 17 March 24

Ontario Ontario reports Emergency Ontario
confirms first first COVID-19 Declaration reports first
case of death deaths (2) in
COVID-19 (from March 11) LTC homes

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Future Outlook
COVID-19: Using Models to Inform Ontario’s Planning

• Models are used to help plan for what could happen.

• As with any model, the farther out predicted, the more uncertainty there is in the
predictions.
• There is more confidence in the projections for the next 30 days than in the longer term
projections.
• Assumptions were used to inform the model.
• Experts modelled how the disease spreads based on observed data and what is known
from other countries.
• Any benefit seen in the model from improved public health measures assumes people
follow those measures.
• If there are people with COVID-19 infections moving between health care facilities, there
could be larger outbreaks.

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 Cumulative Confirmed COVID-19 Cases, Number of
Days since the 100th Case

98,000

Data from: Dong, E., Du, H., & Gardner, L. (2020). An interactive web-based dashboard to track COVID-19 in real time. The Lancet Infectious Diseases, as of April 2, 2020.
Data compiled by Johns Hopkins University from the following sources: WHO, CDC, ECDC, NHC, DXY, 1point3acres, Worldometers.info, BNO, state and national government health
department, and local media reports.
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Projected Ontario Cases by April 30, 2020
400,000

300,000
300,000

220,000 cases
200,000
prevented by
current action

100,000
80,000

12,500
0
R0 2.5,No
little control (baseline)
Intervention Current projection
Current Intervention Improved
Full Futurecontrol today
Intervention
Scenario

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Projected Ontario Deaths by April 30, 2020
7000

6,000
6000

5000

4,400 deaths
4000
prevented by
current action

3000

2000 1,600

1000
200

0
R0 2.5, little control (baseline)
No Intervention Current projection
Current Intervention Improved control
Full Future today
Intervention
Scenario

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 Projected Ontario Deaths over Course of Pandemic

120,000

100,000
100,000

80,000

60,000

40,000

20,000 3,000 to 15,000

0
Without Public Health Measures With Public Health Measures

Projected Deaths

Note: Range depends on implementation of maximum public health measures

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 Ontario ICU Capacity for COVID-19
3800

3600

3400

3200

3000

2800

2600

2400

2200

2000

1800

1600
Known expansion capacity
1400 900 additional planned ICU beds for COVID19 patients
1200

1000Current available capacity

800 410 available ICU beds for COVID19 patients
in addition to beds currently filled with COVID19 patients
600

400

200

0
19-Mar
20-Mar
21-Mar
22-Mar
23-Mar
24-Mar
25-Mar
26-Mar
27-Mar
28-Mar
29-Mar
30-Mar
31-Mar
01-Apr
02-Apr
03-Apr
04-Apr
05-Apr
06-Apr
07-Apr
08-Apr
09-Apr
10-Apr
11-Apr
12-Apr
13-Apr
14-Apr
15-Apr
16-Apr
17-Apr
18-Apr
19-Apr
20-Apr
21-Apr
22-Apr
23-Apr
24-Apr
25-Apr
26-Apr
27-Apr
28-Apr
29-Apr
30-Apr
Ontario confirmed COVID19 ICU cases Expected
Best Case Worst case
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Looking Ahead
COVID-19: Slowing the Spread

• We need you to help us change the outcomes for Ontarians by staying at home and
physically distancing.

• Our public health measures so far have made a difference and we need everyone to
stay focused on these: stay home, stop the spread, stay safe.

• We need everyone to help stop the spread so we all must continue to fully adhere to
the public health measures that have been put in place. We want to avoid the health
care system being overwhelmed and the consequences to Ontarians, as we have seen
in other jurisdictions in Europe and in the United States.

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COVID-19: Additional Public Health Measures

Immediate Focus
• Enhanced capacity for case and contact tracing is underway.
• Increased testing for COVID-19, with a focus on long-term care, retirement homes
and other congregate settings.

Future Measures
• Reduce the number and types of essential workplaces.
• Enhance focus on enforcement and fines for non-compliance.
• Expand direction/guidance on physical distancing, including retail settings.
• Enhanced support for elderly, homeless and other vulnerable populations and
communities.
• Consider entry restrictions in some communities including First Nations.
• Human resource management (movement of health care workers between settings).
• Use of technology to reinforce self-isolation (alerts).
• Additional public education and communication (shelter in place with limited
exceptions).

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